MRD-directed therapy in CLL: ready for prime time?

In recent years, the treatment paradigm for patients with chronic lymphocytic leukemia (CLL) has moved away from chemoimmunotherapy (CIT) toward the use of novel targeted agents. Commercially available drugs, including Bruton's tyrosine kinase inhibitors and the BCL2 inhibitor venetoclax, often used in combination with anti-CD20 monoclonal antibodies, are now the mainstay of therapy both in the frontline and in relapsed settings. As the landscape for CLL management evolves, therapeutic endpoints need to be redefined. Detection of measurable residual disease (MRD) is a sensitive tool to identify disease burden following treatment with several therapeutic regimens in CLL (including CIT, venetoclax-based regimens, and cellular therapies), and it has demonstrated prognostic value. Despite recent advances, the utility of MRD-directed therapy and attempts to eradicate it in routine clinical practice remain debated. There is little comparative data from clinical trials on the best assay to determine undetectable MRD (U-MRD) and whether its monitoring can lead to changes in treatment strategies. Our review discusses the definitions of MRD, assays for its detection, and its impact on long-term survival outcomes for patients with a CLL diagnosis.

Structural Features and Optical Properties of All-Inorganic Zero-Dimensional Halides Cs4PbBr6-xIx Obtained by Mechanochemistry.

Despite the great success of hybrid CH3NH3PbI3 perovskite in photovoltaics, ascribed to its excellent optical absorption properties, its instability toward moisture is still an insurmountable drawback. All-inorganic perovskites are much less sensitive to humidity and have potential interest for solar cell applications. Alternative strategies have been developed to design novel materials with appealing properties, which include different topologies for the octahedral arrangements from three-dimensional (3D, e.g., CsPbBr3 perovskite) or two-dimensional (2D, e.g., CsPb2Br5) to zero-dimensional (0D, i.e., without connection between octahedra), as the case of Cs4PbX6 (X = Br, I) halides. The crystal structure of these materials is complex, and their thermal evolution is unexplored. In this work, we describe the synthesis of Cs4PbBr6-xIx (x = 0, 2, 4, 6) halides by mechanochemical procedures with green credentials; these specimens display excellent crystallinity enabling a detailed structural investigation from synchrotron X-ray powder diffraction (SXRD) data, essential to revisit some features in the temperature range of 90-298 K. In all this regime, the structure is defined in the trigonal R3̅c space group (#167). The presence of Cs and X vacancies suggests some ionic mobility into the crystal structure of these 0D halides. Bond valence maps (BVMs) are useful in determining isovalent surfaces for both Cs4PbBr6 and Cs4PbI6 phases, unveiling the likely ionic pathways for cesium and bromide ions and showing a full 3D connection in the bromide phase, in contrast to the iodide one. On the other hand, the evolution of the anisotropic displacement parameters is useful to evaluate the Debye temperatures, confirming that Cs atoms have more freedom to move, while Pb is more confined at its site, likely due to a higher covalency degree in Pb-X bonds than that in Cs-X bonds. Diffuse reflectance ultraviolet-visible (UV-vis) spectroscopy shows that the optical band gap can be tuned depending on iodine content (x) in the range of 3.6-3.06 eV. From density functional theory (DFT) simulations, the general trend of reducing the band gap when Br is replaced by I is well reproduced.

Phylogenetic description of Trypanosoma cruzi isolates from Dipetalogaster maxima: Occurrence of TcI, TcIV, and TcIV-USA.

Trypanosoma cruzi is the parasite responsible for Chagas disease. The parasite has been classified into six taxonomic assemblages: TcI-TcVI and TcBat (aka Discrete Typing Units or Near-Clades). No studies have focused on describing the genetic diversity of T. cruzi in the northwestern region of Mexico. Within the Baja California peninsula lives Dipetalogaster maxima, the largest vector species for CD. The study aimed to describe the genetic diversity of T. cruzi within D. maxima. A total of three Discrete Typing Units (DTUs) were found (TcI, TcIV, and TcIV-USA). TcI was the predominant DTU found (∼75% of samples), in concordance with studies from the southern USA, one sample was described as TcIV while the other ∼20% pertained to TcIV-USA, which has recently been proposed to have enough genetic divergence from TcIV, to merit its own DTU. Potential phenotype differences between TcIV and TcIV-USA should be assessed in future studies.

PortAqua: a low-cost, compact water quality meter for science communication.

Water quality monitoring allows communities to achieve sustainable management of water resources, which is crucial for life-supporting processes. Water quality is determined by measuring chemical, physical, and biological parameters, requiring sophisticated meters and trained specialists to perform the measurement. However, in low-income communities, water quality is determined by using human senses-smell, color, and taste-since meter acquisition is limited by costs and most people do not know how to monitor water quality. Therefore, accessible technology is necessary to empower communities to have a sustainable lifestyle. In this paper, we present the design and implementation of PortAqua, a 2-parameter water quality meter (WQM), to promote training on water quality measurement. Using basic electronic components, PortAqua is capable of measuring pH with an error of 0.4, and conductivity with an error of 33% at 85 µS cm-1, and 8.7% at 1413 µS cm-1. To demonstrate its preliminary effectiveness as a WQM and its science communication capabilities, the meter has been used in a hands-on workshop with undergraduate and graduate students. During the workshop, attendees participated in a short lecture about water quality measurement techniques and local regulations. Then, they collected water samples from a local source, measured the samples using PortAqua, and discussed the results based on the concepts and regulations. The workshop's effectiveness was evaluated through pre- and post-assessments which revealed increased knowledge of water quality regulations, measurement, and parameters at the end of the activity.

Crystal structure thermal evolution and novel orthorhombic phase of methylammonium lead bromide, CH3NH3PbBr3.

Methylammonium (MA) lead trihalide perovskites, CH3NH3PbX3 (X = I, Br, Cl), have emerged as a new class of light-absorbing materials for photovoltaic applications, reaching efficiencies of 23% when implemented in solar cell heterojunctions. In particular, MAPbBr3 is a promising member with a large bandgap that gives rise to a high open circuit voltage. Here we present a structural study from neutron diffraction (ND) data of an undeuterated MAPbBr3 specimen, carried out to follow its crystallographic behaviour in the 2-298 K temperature range. Besides the known crystallographic phases, i.e. the high-temperature Pm[Formula: see text]m cubic structure, the intermediate I4/mcm tetragonal symmetry and the low-temperature Pnma orthorhombic phase, we additionally identified, from a detailed sequential ND analysis, a novel intermediate phase within the 148.5-154.0 K temperature range as an orthorhombic Imma structure, early associated with a coexistence of phases. Moreover, our ND data allowed us to unveil the configuration of the organic MA units and their complete localization within the mentioned temperature range, thus improving the crystallographic description of this compound. The evolution with temperature of the H-bonds between the organic molecule and the inorganic cage is also followed. A deep knowledge of the crystal structure and, in particular, the MA conformation inside the perovskite cage seems essential to establish structure-property correlations that may drive further improvements.

NUTM1 -rearranged Carcinoma of the Thyroid : A Distinct Subset of NUT Carcinoma Characterized by Frequent NSD3 - NUTM1 Fusions.

NUT carcinoma (NC) is a rare subtype of squamous cell carcinoma defined by NUTM1 rearrangements encoding NUT fusion oncoproteins (the most frequent fusion partner being BRD4 ) that carries a very poor prognosis, with most patients dying in under 1 year. Only rare primary thyroid NCs have been reported. Here, we evaluated a series of 14 cases. The median patient age at diagnosis was 38 years (range: 17 to 72 y). Eight of 13 cases with slides available for review (62%) showed a morphology typical of NC, whereas 5 (38%) had a non-NC-like morphology, some of which had areas of cribriform or fused follicular architecture resembling a follicular cell-derived thyroid carcinoma. For cases with immunohistochemistry results, 85% (11/13) were positive for NUT on biopsy or resection, though staining was significantly decreased on resection specimens due to fixation; 55% (6/11) were positive for PAX8, and 54% (7/13) for TTF-1. Tumors with a non-NC-like morphology were all positive for PAX8 and TTF-1. The fusion partner was known in 12 cases: 9 (75%) cases had a NSD3-NUTM1 fusion, and 3 (25%) had a BRD4-NUTM1 fusion. For our cohort, the 2-year overall survival (OS) was 69%, and the 5-year OS was 58%. Patients with NC-like tumors had a significantly worse OS compared with that of patients with tumors with a non-NC-like morphology ( P =0.0462). Our study shows that NC of the thyroid can mimic other thyroid primaries, has a high rate of NSD3 - NUTM1 fusions, and an overall more protracted clinical course compared with nonthyroid primary NC.

Potential distributions of the parasite Trypanosoma cruzi and its vector Dipetalogaster maxima highlight areas at risk of Chagas disease transmission in Baja California Sur, Mexico, under climate change.

Dipetalogaster maxima is a primary vector of Chagas disease in the Cape region of Baja California Sur, Mexico. The geographic distribution of D. maxima is limited to this small region of the Baja California Peninsula in Mexico. Our study aimed to construct the ecological niche models (ENMs) of this understudied vector species and the parasite responsible for Chagas disease (Trypanosoma cruzi). We modelled the ecological niches of both species under current and future climate change projections in 2050 using four Representative Concentration Pathways (RCPs): RCP 2.6, RCP 4.5, RCP 6.0, and RCP 8.5. We also assessed the human population at risk of exposure to D. maxima bites, the hypothesis of ecological niche equivalency and similarity between D. maxima and T. cruzi, and finally the abundance centroid hypothesis. The ENM predicted a higher overlap between both species in the Western and Southern coastal regions of the Baja California Peninsula. The climate change scenarios predicted a Northern shift in the ecological niche of both species. Our findings suggested that the highly tourist destination of Los Cabos is a high-risk zone for Chagas disease circulation. Overall, the study provides valuable data to vector surveillance and control programs.

Detailed Structural Features of the Perovskite-Related Halide RbPbI3 for Solar Cell Applications.

All-inorganic lead halide perovskites like CsPbBr3, CsPbI3, or RbPbI3 are good replacements for the classical hybrid organic-inorganic perovskites like CH3NH3PbI3, susceptible to fast degradation in the presence of humid air. They also exhibit outstanding light absorption properties suitable for solar energy applications. Here, we describe the synthesis of RbPbI3 by mechanochemical procedures with green credentials, avoiding toxic or expensive organic solvents; this specimen exhibits excellent crystallinity. We report neutron powder diffraction data, essential to revisit some subtle structural features around room temperature (200-400 K). In all these regimes, the orthorhombic Pnma crystal structure is characterized by the presence along the b direction of the crystal of double rows of edge-sharing PbI6 octahedra. The lone electron pairs of Pb2+ ions have a strong stereochemical effect on the PbI6 octahedral distortion. The relative covalency of Rb-I versus Pb-I bonds shows that the Pb-I-related motions are more rigid than Rb-I-related vibrations, as seen in the Debye temperatures from the evolution of the anisotropic displacements. The optical gap, measured by diffuse reflectance UV-vis spectroscopy, is ∼2.51 eV and agrees well with ab initio calculations. The thermoelectric Seebeck coefficient is 3 orders of magnitude larger than that of other halide perovskites, with a value of ∼117,000 µV·K-1 at 460 K.

Haemophagocytic lymphohistiocytosis following COVID-19 mRNA vaccination.

The development of vaccinations has been instrumental in the ongoing effort to combat the COVID-19 pandemic. Although the benefits of vaccination are unquestionable, there have been reports of potentially rare life-threatening complications following vaccination including thrombocytopaenia, haemolytic anaemia, vasculitis and myocarditis. Haemophagocytic lymphohistiocytosis (HLH), a rare but life-threatening inflammatory condition, has also been described postadenoviral vector COVID-19 vaccination but it has never been reported post-messenger RNA (mRNA) COVID-19 vaccination. We report two cases of HLH admitted to our hospital after administration of COVID-19 mRNA vaccines. We also searched the vaccine adverse event reporting system and found 50 reports of suspected HLH following COVID-19 vaccination. Presently, we cannot define a causality between COVID-19 mRNA vaccination and HLH development. However, we hope the reporting of our two cases (and additional cases seen in the adverse event reporting database) will help us determine whether there is a potential relationship. Prompt recognition of this condition is of utmost importance to initiate life-saving therapy.

Phylogenetic diversity of two common Trypanosoma cruzi lineages in the Southwestern United States.

Trypanosoma cruzi is the causative agent of Chagas disease, a devastating parasitic disease endemic to Central and South America, Mexico, and the USA. We characterized the genetic diversity of Trypanosoma cruzi circulating in five triatomine species (Triatoma gerstaeckeri, T. lecticularia, T.indictiva, T. sanguisuga and T. recurva) collected in Texas and Southern Arizona using multilocus sequence typing (MLST) with four single-copy loci (cytochrome oxidase subunit II- NADH dehydrogensase subunit 1 region (COII-ND1), mismatch-repair class 2 (MSH2), dihydrofolate reductase-thymidylate synthase (DHFR-TS) and a nuclear gene with ID TcCLB.506529.310). All T. cruzi variants fall in two main genetic lineages: 75% of the samples corresponded to T. cruzi Discrete Typing Unit (DTU) I (TcI), and 25% to a North American specific lineage previously labelled TcIV-USA. Phylogenetic and sequence divergence analyses of our new data plus all previously published sequence data from those four loci collected in the USA, show that TcIV-USA is significantly different from any other previously defined T. cruzi DTUs. The significant level of genetic divergence between TcIV-USA and other T. cruzi DTUs should lead to an increased focus on understanding the epidemiological importance of this DTU, as well as its geographical range and pathogenicity in humans and domestic animals. Our findings further corroborate the fact that there is a high genetic diversity of the parasite in North America and emphasize the need for appropriate surveillance and vector control programs for Chagas disease in southern USA and Mexico.

The couple's tree of life: Promoting and protecting relational identity.

We present The Couple's Tree of Life (CTOL) as a new collective narrative methodology to strengthen couple relationships and prevent conflicts. The CTOL, based on the tree of life methodology (Ncube & Denborough, Tree of Life, mainstreaming psychosocial care and support: a manual for facilitators, REPSSI, 2007), aims to reinforce the identity and strengths of the couple. We explain the CTOL implementation process and illustrate it step by step with a group of 14 adult heterosexual Caucasian couples who belonged to Protestant churches in Madrid (Spain). As a way to assess its usefulness before applying the CTOL to other groups of couples, we conducted a pre-post evaluation using the Dyadic Adjustment Scale of Spanier(1976). We found an improvement in dyadic adjustment, quality, understanding of, and satisfaction with, the relationship. The results, though not generalizable at this stage, suggest that the CTOL could reinforce the couple's identity while maintaining individual identities. We also discuss the possible applications of couples therapy.

Presentamos El árbol de la vida de la pareja (CTOL, por sus siglas en inglés) como una nueva metodología narrativa colectiva, con el fin de fortalecer las relaciones de pareja y para la prevención de conflictos. El CTOL, basado en la metodología del árbol de la vida (Ncube & Denborough, Tree of Life, mainstreaming psychosocial care and support: a manual for facilitators, REPSSI, 2007), tiene como finalidad reforzar la identidad y las fortalezas de la pareja. Explicamos el proceso de implementación del CTOL y lo ejemplificamos paso a paso con un grupo de 14 parejas heterosexuales caucásicas adultas que pertenecían a iglesias protestantes en Madrid (España). Como forma de evaluar su utilidad antes de aplicar el CTOL a otros grupos de parejas, realizamos una evaluación previa y posterior utilizando la Escala de Ajuste Diádico de Spanier (1976). Hallamos una mejora en el ajuste diádico, en la calidad, en la comprensión de la relación y en la satisfacción con esta. Los resultados, aunque no son generalizables en esta etapa, sugieren que el árbol de la vida de la pareja podría reforzar la identidad de la pareja y a la vez mantener las identidades individuales. También explicamos las posibles aplicaciones a la terapia de pareja.

Tromboembolia pulmonar e infarto de miocardio embólico en paciente con trombo en tránsito a través de foramen oval permeable / Pulmonary embolism and embolic myocardial infarction in a patient with thrombi in transit through a patent foramen ovale

Resumen Se presenta el caso de una paciente ingresada por cuadro clínico de infarto agudo de miocardio con elevación del segmento ST. Tras la realización de una coronariografía emergente en la que se evidencia un trombo en la arteria coronaria derecha, sin objetivar lesiones ateroscleróticas, es diagnosticada de infarto de probable origen embólico. Tras realizar un ecocardiograma transtorácico, se detecta la presencia de trombos en las cavidades derechas e izquierdas del corazón. Por ello se realiza angiografía por tomografía computarizada con protocolo de embolia pulmonar, que confirma la presencia de embolia pulmonar bilateral masiva. Tras esto, se repitió el ecocardiograma transtorácico, hallándose un aneurisma del septo interauricular, con aparente protrusión de una masa trombótica a través de él. Se inició terapia anticoagulante con buena evolución por parte de la paciente, habiendo desaparecido los trombos en el ecocardiograma con test de burbujas que se realizó días después, en el que se demostró la presencia de un foramen oval permeable. Con la presentación de este caso se pretende, en primer lugar, ilustrar una afección que en contadas ocasiones se puede objetivar mediante prueba de imagen, y en segundo lugar, hacer una breve revisión del diagnóstico y el manejo del foramen oval permeable como parte del estudio de fuente embólica.

Abstract The authors describe a case of a patient admitted with ST elevation myocardial infarction. An emergent coronariography was done, showing a thrombus in the right coronary artery, without evidence of atherosclerotic lesions in the coronary bed. Due to this, she is diagnosed with probable embolic myocardial infarction. When she was performed a transthoracic echocardiography, the presence of free thrombi was detected in right and left chambers of the heart. Due to this, a CT angiography with pulmonary embolism protocol was done, confirming the presence of a massive bilateral pulmonary embolism. After that, a new trans-thoracic echocardiography was done, finding an aneurism at interatrial septum, with an apparent protrusion of thrombotic mass through it. The decision taken was initiating therapeutic anticoagulation, having the patient a positive evolution with disappearance of thrombi in the bubble test performed days later, and showing the presence of a patent foramen ovale. The purpose of the presentation of this case report is, firstly, illustrating an entity which in very few occasions can be demonstrated by imaging tests, and secondly, making a brief review of the diagnosis and management of the patent foramen ovale as a part of the study of embolic sources.

Autologous Dendritic Cells in Combination With Chemotherapy Restore Responsiveness of T Cells in Breast Cancer Patients: A Single-Arm Phase I/II Trial.

Introduction: Animal studies and preclinical studies in cancer patients suggest that the induction of immunogenic cell death (ICD) by neoadjuvant chemotherapy with doxorubicin and cyclophosphamide (NAC-AC) recovers the functional performance of the immune system. This could favor immunotherapy schemes such as the administration of antigen-free autologous dendritic cells (DCs) in combination with NAC-AC to profit as cryptic vaccine immunogenicity of treated tumors. Objective: To explore the safety and immunogenicity of autologous antigen-free DCs administered to breast cancer patients (BCPs) in combination with NAC-AC. Materials and Methods: A phase I/II cohort clinical trial was performed with 20 BCPs treated with NAC-AC [nine who received DCs and 11 who did not (control group)]. The occurrence of adverse effects and the functional performance of lymphocytes from BCPs before and after four cycles of NAC-AC receiving DCs or not were assessed using flow cytometry and compared with that from healthy donors (HDs). Flow cytometry analysis using manual and automated algorithms led us to examine functional performance and frequency of different lymphocyte compartments in response to a stimulus in vitro. This study was registered at clinicaltrials.gov (NCT03450044). Results: No grade II or higher adverse effects were observed associated with the transfer of DCs to patients during NAC-AC. Interestingly, in response to the in vitro stimulation, deficient phosphorylation of Zap70 and AKT proteins observed before chemotherapy in most patients' CD4 T cells significantly recovered after NAC-AC only in patients who received DCs. Conclusions: The transfer of autologous DCs in combination with NAC-AC in BCPs is a safe procedure. That, in BCPs, the administration of DCs in combination with NAC-AC favors the recovery of the functional capacity of T cells suggests that this combination may potentiate the adjuvant effect of ICD induced by NAC-AC on T cells and, hence, potentiate the immunogenicity of tumors as cryptic vaccines.

Understanding the Origin of Enhanced Piezoelectric Response in PVDF Matrices with Embedded ZnO Nanoparticles, from Polarizable Molecular Dynamics Simulations.

The pervasive use of portable electronic devices, powered from rechargeable batteries, represents a significant portion of the electricity consumption in the world. A sustainable and alternative energy source for these devices would require unconventional power sources, such as harvesting kinetic/potential energy from mechanical vibrations, ultrasound waves, and biomechanical motion, to name a few. Piezoelectric materials transform mechanical deformation into electric fields or, conversely, external electric fields into mechanical motion. Therefore, accurate prediction of elastic and piezoelectric properties of materials, from the atomic structure and composition, is essential for studying and optimizing new piezogenerators. Here, we demonstrate the application of harmonic-covalent and reactive force fields (FF), Dreiding and ReaxFF, respectively, coupled to the polarizable charge equilibration (PQEq) model for predicting the elastic moduli and piezoelectric response of crystalline zinc oxide (ZnO) and polyvinylidene difluoride (PVDF). Furthermore, we parametrized the ReaxFF atomic interactions for Zn-F in order to characterize the interfacial effects in hybrid PVDF matrices with embedded ZnO nanoparticles (NPs). We capture the nonlinear piezoelectric behavior of the PVDF-ZnO system at different ZnO concentrations and the enhanced response that was recently observed experimentally, between 5 and 7 wt % ZnO concentrations. From our simulation results, we demonstrate that the origin of this enhancement is due to an increase in the total atomic stress distribution at the interface between the two materials. This result provides valuable insight into the design of new and improved piezoelectric nanogenerators and demonstrates the practical value of these first-principles based modeling methods in materials science.

Usefulness of IL-21, IL-7, and IL-15 conditioned media for expansion of antigen-specific CD8+ T cells from healthy donor-PBMCs suitable for immunotherapy.

Clonal anergy and depletion of antigen-specific CD8+ T cells are characteristics of immunosuppressed patients such as cancer and post-transplant patients. This has promoted translational research on the adoptive transfer of T cells to restore the antigen-specific cellular immunity in these patients. In the present work, we compared the capability of PBMCs and two types of mature monocyte-derived DCs (moDCs) to prime and to expand ex-vivo antigen-specific CD8+ T cells using culture conditioned media supplemented with IL-7, IL-15, and IL-21. The data obtained suggest that protocols involving moDCs are as efficient as PBMCs-based cultures in expanding antigen-specific CD8+ T cell to ELA and CMV model epitopes. These three gamma common chain cytokines promote the expansion of naïve-like and central memory CD8+ T cells in PBMCs-based cultures and the expansion of effector memory T cells when moDCs were used. Our results provide new insights into the use of media supplemented with IL-7, IL-15, and IL-21 for the in-vitro expansion of early-differentiated antigen-specific CD8+ T cells for immunotherapy purposes.

Food Intake During Cancer Therapy: A Systematic Review.

AIM: Conduct a systematic review of available evidence on food and beverage intake during cancer treatment. OBJECTIVE: Determine what food or beverages consumed during cancer treatment might prevent recurrence, subsequent malignancies, treatment-related toxicity, or death. BACKGROUND: Food and beverage intake, as well as weight status, can integrate with cancer treatment to mitigate treatment-related toxicities, support treatment success, and prevent recurrence. Yet, evidence-based recommendations are lacking. METHODS: We searched PubMed, Embase, and Cochran for research studies conducted within the last 10 years on food and beverage consumption during cancer treatment, with no restrictions on age or cancer type. Two reviewers independently extracted information on intervention type, diet, and outcomes; these data were confirmed by a third reviewer. RESULTS: Nineteen studies were selected from 1551 potential studies. Nine were randomized controlled trials, analyzing high protein diets, short-term fasting, low-fat diets, FODMAP diet, or comparing consumption of 1 specific food or nutrient, including Concord grape juice, onions, and fiber. The remaining 10 studies were observational or retrospective and tracked treatment symptoms, general dietary intake, or weight status as well as consumption of specific foods including nuts, coffee, sugar-sweetened beverages. CONCLUSIONS: Available evidence suggests food can be effective at ameliorating cancer treatment-related toxicities and improving prognosis, but more research is needed.

A continuum thermomechanical model for the electrosurgery of soft hydrated tissues using a moving electrode.

Electrosurgical radio-frequency heating of tissue is widely applied in minimally invasive surgical procedures to dissect tissue with simultaneous coagulation to obtain hemostasis. The tissue effect depends on the cumulative heating that occurs in the vicinity of the moving blade electrode. In this work, a continuum thermomechanical model based on mixture theory, which accounts for the multiphase nature of soft hydrated tissues and includes transport and evaporation losses, is used to capture the transient heating effect of a moving electrode. The model takes into account the dependence of electrical conductivity and the evaporation rate on the water content in the tissue, as it changes in response to heating. Temperature prediction is validated with mean experimental temperature measured during in situ experiments performed on porcine liver tissue at different power settings of the electrosurgical unit. The model is shown to closely capture the temperature variation in the tissue for three distinct scenarios; with no visible cutting or coagulation damage at a low 10 W power setting, with coagulation damage but no tissue cutting at an intermediate power setting of 25 W, and with both coagulation and tissue cutting at a higher power setting of 50 W. Furthermore, an Arrhenius model is shown to capture tissue damage observed in the experiments. Increase in applied power was found to correlate with tissue cutting and concentrated damage near the electrode, but had little effect on the observed coagulation damage width. The proposed model provides, for the first time, an accurate tool for predicting temperature rise and evolving damage resulting from a moving electrode in pure-cut electrosurgery.

Enhanced stability in CH3NH3PbI3 hybrid perovskite from mechano-chemical synthesis: structural, microstructural and optoelectronic characterization.

Among the hybrid organic-inorganic perovskites MAPbX3 (MA: methyl-ammonium CH3-NH3+, X = halogen), the triiodide specimen (MAPbI3) is still the material of choice for solar energy applications. Although it is able to absorb light above its 1.6 eV bandgap, its poor stability in humid air atmosphere has been a major drawback for its use in solar cells. However, we discovered that this perovskite can be prepared by ball milling in a straightforward way, yielding specimens with a superior stability. This fact allowed us to take atomic-resolution STEM images for the first time, with sufficient quality to unveil microscopic aspects of this material. We demonstrated full Iodine content, which might be related to the enhanced stability, in a more compact PbI6 framework with reduced unit-cell volume. A structural investigation from neutron powder diffraction (NPD) data of an undeuterated specimen was essential to determine the configuration of the organic MA unit in the 100-298 K temperature range. A phase transition is identified, from the tetragonal structure observed at RT (space group I4/mcm) to an orthorhombic (space group Pnma) phase where the methyl-ammonium organic units are fully localized. Our NPD data reveal that the MA changes are gradual and start before reaching the phase transition. Optoelectronic measurements yield a photocurrent peak at an illumination wavelength of 820 nm, which is redshifted by 30 nm with respect to previously reported measurements on MAPbI3 perovskites synthesized by crystallization from organic solvents.